DNA mismatch repair and the transition to hormone independence in breast and prostate cancer

The molecular basis for the progression of breast and prostate cancer from hormone dependent to hormone independent disease remains a critical issue in the management of these two cancers. The DNA mismatch repair system is integral to the maintenance of genomic stability and suppression of tumorigenesis. No firm consensus exists regarding the implications of mismatch repair (MMR) deficiencies in the development of breast or prostate cancer. However, recent studies have reported an association between mismatch repair deficiency and loss of specific hormone receptors, inferring a potential role for mismatch repair deficiency in this transition. An updated review of the experimental data supporting or contradicting the involvement of MMR defects in the development and progression of breast and prostate cancer will be provided with particular emphasis on their implications in the transition to hormone independence.

Mycosis fungoides shows concurrent deregulation of multiple genes involved in the TNF signaling pathway:an expression profile study

Mycosis fungoides (MF) is the most frequent type of cutaneous T-cell lymphoma, whose diagnosis and study is hampered by its morphologic similarity to inflammatory dermatoses (ID) and the low proportion of tumoral cells, which often account for only 5% to 10% of the total tissue cells. cDNA microarray studies using the CNIO OncoChip of 29 MF and 11 ID cases revealed a signature of 27 genes implicated in the tumorigenesis of MF, including tumor necrosis factor receptor (TNFR)-dependent apoptosis regulators, STAT4, CD40L, and other oncogenes and apoptosis inhibitors. Subsequently a 6-gene prediction model was constructed that is capable of distinguishing MF and ID cases with unprecedented accuracy. This model correctly predicted the class of 97% of cases in a blind test validation using 24 MF patients with low clinical stages. Unsupervised hierarchic clustering has revealed 2 major subclasses of MF, one of which tends to include more aggressive-type MF cases including tumoral MF forms. Furthermore, signatures associated with abnormal immunophenotype (11 genes) and tumor stage disease (5 genes) were identified.

Pathogenesis of prostate cancer and hormone refractory prostate cancer

Prostate cancer is the second most common malignancy in males and the leading cause of cancer death. Prostate cancer is initially androgen dependent and relies upon the androgen receptor (AR) to mediate the effects of androgens. The AR is also the target for therapy using antiandrogens and LHRH analogues. However, all cancers eventually become androgen independent, often referred to as hormone refractory prostate cancer. The processes involved in this transformation are yet to be fully understood but research in this area has discovered numerous potential mechanisms including AR amplification, over-expression or mutation and alterations in the AR signaling pathway. This review of the recent literature examines the current knowledge and developments in the understanding of the molecular biology of prostate cancer and hormone refractory prostate cancer, summarizing the well characterized pathways involved as well as introducing new concepts that may offer future solutions to this difficult problem.

Huntingtin interacting protein 1 modulates the transcriptional activity of nuclear hormone receptors

Internalization of activated receptors regulates signaling, and endocytic adaptor proteins are well-characterized in clathrin-mediated uptake. One of these adaptor proteins, huntingtin interacting protein 1 (HIP1), induces cellular transformation and is overexpressed in some prostate cancers. We have discovered that HIP1 associates with the androgen receptor through a central coiled coil domain and is recruited to DNA response elements upon androgen stimulation. HIP1 is a novel androgen receptor regulator, significantly repressing transcription when knocked down using a silencing RNA approach and activating transcription when overexpressed. We have also identified a functional nuclear localization signal at the COOH terminus of HIP1, which contributes to the nuclear translocation of the protein. In conclusion, we have discovered that HIP1 is a nucleocytoplasmic protein capable of associating with membranes and DNA response elements and regulating transcription.

Dynamic axle force and road profile identification using a moving vehicle

The axle forces applied by a vehicle through its wheels are a critical part of the interaction between vehicles, pavements and bridges. Therefore, the minimisation of these forces is important in order to promote long pavement life spans and ensure that bridge loads are small. Moreover, as the road surface roughness affects the vehicle dynamic forces, the monitoring of pavements for highways and bridges is an important task. This paper presents a novel algorithm to identify these dynamic interaction forces which involves direct instrumentation of a vehicle with accelerometers. The ability of this approach to predict the pavement roughness is also presented. Moving force identification theory is applied to a vehicle model in theoretical simulations in order to obtain the interaction forces and pavement roughness from the measured accelerations. The method is tested for a range of bridge spans in simulations and the influence of road roughness level on the accuracy of the results is investigated. Finally, the challenge for the real-world problem is addressed in a laboratory experiment.

Predicting conversion to dementia in a memory clinic: A standard clinical approach compared with an empirically defined clustering method (latent profile analysis) for mild cognitive impairment subtyping

Introduction
Mild cognitive impairment (MCI) has clinical value in its ability to predict later dementia. A better understanding of cognitive profiles can further help delineate who is most at risk of conversion to dementia. We aimed to (1) examine to what extent the usual MCI subtyping using core criteria corresponds to empirically defined clusters of patients (latent profile analysis [LPA] of continuous neuropsychological data) and (2) compare the two methods of subtyping memory clinic participants in their prediction of conversion to dementia.

Methods
Memory clinic participants (MCI, n = 139) and age-matched controls (n = 98) were recruited. Participants had a full cognitive assessment, and results were grouped (1) according to traditional MCI subtypes and (2) using LPA. MCI participants were followed over approximately 2 years after their initial assessment to monitor for conversion to dementia.

Results
Groups were well matched for age and education. Controls performed significantly better than MCI participants on all cognitive measures. With the traditional analysis, most MCI participants were in the amnestic multidomain subgroup (46.8%) and this group was most at risk of conversion to dementia (63%). From the LPA, a three-profile solution fit the data best. Profile 3 was the largest group (40.3%), the most cognitively impaired, and most at risk of conversion to dementia (68% of the group).

Discussion
LPA provides a useful adjunct in delineating MCI participants most at risk of conversion to dementia and adds confidence to standard categories of clinical inference.

Addition of docetaxel, zoledronic acid, or both to first-line long-term hormone therapy in prostate cancer (STAMPEDE): survival results from an adaptive, multiarm, multistage, platform randomised controlled trial

BACKGROUND: Long-term hormone therapy has been the standard of care for advanced prostate cancer since the 1940s. STAMPEDE is a randomised controlled trial using a multiarm, multistage platform design. It recruits men with high-risk, locally advanced, metastatic or recurrent prostate cancer who are starting first-line long-term hormone therapy. We report primary survival results for three research comparisons testing the addition of zoledronic acid, docetaxel, or their combination to standard of care versus standard of care alone.

METHODS: Standard of care was hormone therapy for at least 2 years; radiotherapy was encouraged for men with N0M0 disease to November, 2011, then mandated; radiotherapy was optional for men with node-positive non-metastatic (N+M0) disease. Stratified randomisation (via minimisation) allocated men 2:1:1:1 to standard of care only (SOC-only; control), standard of care plus zoledronic acid (SOC + ZA), standard of care plus docetaxel (SOC + Doc), or standard of care with both zoledronic acid and docetaxel (SOC + ZA + Doc). Zoledronic acid (4 mg) was given for six 3-weekly cycles, then 4-weekly until 2 years, and docetaxel (75 mg/m(2)) for six 3-weekly cycles with prednisolone 10 mg daily. There was no blinding to treatment allocation. The primary outcome measure was overall survival. Pairwise comparisons of research versus control had 90% power at 2·5% one-sided α for hazard ratio (HR) 0·75, requiring roughly 400 control arm deaths. Statistical analyses were undertaken with standard log-rank-type methods for time-to-event data, with hazard ratios (HRs) and 95% CIs derived from adjusted Cox models. This trial is registered at ClinicalTrials.gov (NCT00268476) and ControlledTrials.com (ISRCTN78818544).

FINDINGS: 2962 men were randomly assigned to four groups between Oct 5, 2005, and March 31, 2013. Median age was 65 years (IQR 60-71). 1817 (61%) men had M+ disease, 448 (15%) had N+/X M0, and 697 (24%) had N0M0. 165 (6%) men were previously treated with local therapy, and median prostate-specific antigen was 65 ng/mL (IQR 23-184). Median follow-up was 43 months (IQR 30-60). There were 415 deaths in the control group (347 [84%] prostate cancer). Median overall survival was 71 months (IQR 32 to not reached) for SOC-only, not reached (32 to not reached) for SOC + ZA (HR 0·94, 95% CI 0·79-1·11; p=0·450), 81 months (41 to not reached) for SOC + Doc (0·78, 0·66-0·93; p=0·006), and 76 months (39 to not reached) for SOC + ZA + Doc (0·82, 0·69-0·97; p=0·022). There was no evidence of heterogeneity in treatment effect (for any of the treatments) across prespecified subsets. Grade 3-5 adverse events were reported for 399 (32%) patients receiving SOC, 197 (32%) receiving SOC + ZA, 288 (52%) receiving SOC + Doc, and 269 (52%) receiving SOC + ZA + Doc.

INTERPRETATION: Zoledronic acid showed no evidence of survival improvement and should not be part of standard of care for this population. Docetaxel chemotherapy, given at the time of long-term hormone therapy initiation, showed evidence of improved survival accompanied by an increase in adverse events. Docetaxel treatment should become part of standard of care for adequately fit men commencing long-term hormone therapy.

FUNDING: Cancer Research UK, Medical Research Council, Novartis, Sanofi-Aventis, Pfizer, Janssen, Astellas, NIHR Clinical Research Network, Swiss Group for Clinical Cancer Research.

Microbiological Profile of Aggressive Periodontitis in a Sudanese Population

Background: Several bacterial species have been identified as being associated with aggressive periodontitis (AgP) notably Aggregatibacter actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg). There are limited data on bacterial associations with AgP in African populations. Objective: To investigate possible associations between specific bacteria and AgP in a Sudanese population. Methods: Subgingival plaque samples were collected from 93 (20 male, 73 female) Sudanese patients diagnosed with AgP and from 72 (23 male, 48 female) periodontally healthy Sudanese controls. Quantitative PCR was used to identify Aa, Pg, Treponema denticola (Td) and Fusobacterium nucleatum (Fn). The prevalence of these bacterial species was compared using Chi-square analysis. Odds ratios (OR) were calculated using standard methods. Results: The cases with AgP were well matched in age with the controls: 24.8 (SD 5.1) compared with 23.5 (SD 3.7) years, p=0.07. There was a significantly higher prevalence of Pg in AgP (73%) than in the controls (33%), p<0.0001. The OR for Pg to be associated with AgP was 5.44 (95% confidence intervals 2.78-10.64). In 26 (38%) of the AgP cases positive for Pg there were low levels of this bacterium (<100 copies). Both Td and Fn were identified in virtually all (>95%) the plaque samples studied from both AgP and controls. Aa was the least frequently identified species and was present in only 28% of AgP and 18% of controls, p=0.14. The OR for Aa to be associated with AgP was slightly increased at 1.76 (95% CI 0.83-3.74), however, this was not significant (p=0.14). Conclusion: In the Sudanese subjects studied Pg but not Aa was associated with AgP. There were very low levels of Pg in many of the plaque samples from AgP.

Risk factors (excluding hormone therapy) for endometrial hyperplasia: a systematic review.

Objective: To conduct a systematic review of risk factors associated with the development of Endometrial Hyperplasia (EH).

Data sources: Ovid MEDLINE, EMBASE and Web of Science databases were searched from inception to 30 June 2015.

Study eligibility: Fifteen observational studies that reported on EH risk in relation to lifestyle factors (n=14), medical history (n=11), reproductive and menstrual history (n=9) and measures of socio-economic status (n=2) were identified. Pooled relative risk estimates and corresponding 95% confidence intervals (CI) were able to be derived for EH and Body Mass Index (BMI), smoking, diabetes and hypertension, using random effects models comparing high versus low categories.

Results: The pooled relative risk for EH when comparing women with the highest versus lowest BMI was 1.82 (95% CI 1.22–2.71; n=7 studies, I2=90.4%). No significant associations were observed for EH risk for smokers compared with non-smokers (RR 0.88, 95% CI 0.66-1.17; n=3, I2=0.0%), hypertensive versus normotensive women (RR 1.51, 95% CI 0.72–3.15; n=5 studies, I2=79.1%), or diabetic versus non-diabetic women (RR 1.77, 95% CI 0.79–3.96; n=5 studies, I2=31.8%) respectively although the number of included studies was limited. There were mixed reports on the relationship between age and risk of EH. Too few studies reported on other factors to reach any conclusions in relation to EH risk.

Conclusions: A high BMI was associated with an increased risk of EH, providing additional rationale for women to maintain a normal body weight. No significant associations were detected for other factors and EH risk, however relatively few studies have been conducted and few of the available studies adequately adjusted for relevant confounders. Therefore, further aetiological studies of endometrial hyperplasia are warranted.

Hα Line Profile Asymmetries and the Chromospheric Flare Velocity Field

The asymmetries observed in the line profiles of solar flares can provide important diagnostics of the properties and dynamics of the flaring atmosphere. In this paper the evolution of the Hα and Ca ii λ8542 lines are studied using high spatial, temporal, and spectral resolution ground-based observations of an M1.1 flare obtained with the Swedish 1 m Solar Telescope. The temporal evolution of the Hα line profiles from the flare kernel shows excess emission in the red wing (red asymmetry) before flare maximum and excess in the blue wing (blue asymmetry) after maximum. However, the Ca ii λ8542 line does not follow the same pattern, showing only a weak red asymmetry during the flare. RADYN simulations are used to synthesize spectral line profiles for the flaring atmosphere, and good agreement is found with the observations. We show that the red asymmetry observed in Hα is not necessarily associated with plasma downflows, and the blue asymmetry may not be related to plasma upflows. Indeed, we conclude that the steep velocity gradients in the flaring chromosphere modify the wavelength of the central reversal in the Hα line profile. The shift in the wavelength of maximum opacity to shorter and longer wavelengths generates the red and blue asymmetries, respectively.

Efeitos genotóxicos e bioquímicos de xenobióticos em animais aquáticos

No presente trabalho, foi estudado um largo espectro de efeitos genotóxicos e bioquímicos na tainha-garrento (Liza aurata). Nos Capítulos II e III são descritos os efeitos de exposição de curta duração ao fenantreno, um hidrocarboneto aromático policíclico (HAP). A exposição de curta duração (16 horas) demonstrou a capacidade deste composto induzir a actividade da enzima de fase I da biotransformação, etoxiresorufina O-desetilase (EROD), provocar decréscimos de integridade no ADN hepático e aumento de anomalias nucleares eritrocíticas (ANE). Em termos de respostas de stresse, os níveis plasmáticos de cortisol e glucose aumentaram face à exposição a este HAP. A exposição ao fenantreno induziu o decréscimo da glutationa peroxidase (GPx) nas guelras, enquanto que no fígado a actividade da GPx aumentou. No rim, a actividade da glutationa S-transferase (GST) foi inibida. Nas guelras, verificou-se um aumento da catalase. O fenantreno demonstrou igualmente a capacidade de induzir um aumento dos níveis de glutationa nas guelras e fígado. Estas respostas demonstraram a sensibilidade de L. aurata, a este HAP, realçando a especificidade das respostas em termos de órgãos. Apesar dos aumentos das defesas antioxidantes, o potencial tóxico deste composto foi demonstrado pelo aumento da peroxidação lipídica nos três órgãos. Nos capítulos seguintes, são descritas as respostas de L. aurata capturada na Ria de Aveiro, em locais com diferentes perfis de contaminação, inicialmente no Outono de 2005 (Capítulos III a IX) e posteriormente analisando respostas sazonais (Capítulos X e XI). A análise de respostas de stresse (cortisol, glucose e lactato) revelou que L. aurata capturada em Vagos (local contaminado por HAPs) apresentava níveis baixos de cortisol, enquanto que no Laranjo (local contaminado por mercúrio) apresentavam elevados níveis de glucose e lactato. Relativamente às hormonas do eixo hipotálamo – hipófise – tiróide (HHT), foram observados elevados níveis plasmáticos da hormona estimuladora da tiróide (TSH) nos organismos capturados no Laranjo, baixos níveis de tiroxina (T4) nos organismos da Barra (local sujeito a tráfego naval) e baixos níveis de triiodotironina (T3) no Rio Novo do Príncipe (próximo de um antigo efluente de pasta de papel), Laranjo e Vagos. A avaliação das defesas antioxidantes, dano oxidativo e genotóxico nas guelras, rim e fígado revelou diferenças significativas nas respostas dos órgãos. L. aurata capturada na Barra apresentou dano oxidativo nas guelras (Capítulo V). No rim foi detectada uma diminuição da integridade do ADN no Rio Novo do Príncipe e Vagos (Capítulo VI), enquanto que no fígado foi observado dano lipídico na Gafanha e Vagos (Capítulo VIII). O dano não esteve sempre associado a um decréscimo das defesas. As análises da água e do sedimento da Ria de Aveiro (Outono de 2005) revelaram elevadas concentrações de metais (Cd, Hg, Cu e Zn),principalmente, no Laranjo e Rio Novo do Príncipe. L. aurata capturada nestes locais apresentou os níveis mais elevados de metalotioninas hepáticas (Capítulo VII) que parecem responsáveis pela inexistência de danos no fígado (Capítulo VIII). O dano oxidativo no ADN, avaliado através da quantificação dos níveis plasmáticos de 8-hidroxi-2-desoxiguanosina (8-OHdG) e o dano clastogénico/aneugénico, avaliado através da quantificação da frequência de ANE, foram estudados, no Outono de 2005, em duas espécies de peixes (L. aurata e Dicentrarchus labrax - robalo) (Capítulo IX). Os resultados revelaram grande sensibilidade de D. labrax em termos de dano oxidativo no ADN na Gafanha, Rio Novo do Príncipe e Vagos, enquanto que L. aurata apresentou dano oxidativo apenas no Laranjo. O aumento da frequência de ANE apenas foi detectado em L. aurata, em Vagos, não se tendo detectado correlação entre estes dois parâmetros. O estudo sazonal (Maio de 2006 a Março de 2007) do dano oxidativo no ADN e frequência de ANE em L. aurata (Capítulo X) demonstrou a variação destes parâmetros com a estação do ano, apesar de não se ter verificado correlação com os parâmetros hidrológicos determinados. No entanto, no local de referência não se verificaram diferenças sazonais, o que sugere que estes biomarcadores reflectem variações de biodisponibilidade de contaminantes. A análise global dos resultados das diferentes estações do ano revelou que L. aurata capturada no Rio Novo do Príncipe e em Vagos apresentou maior susceptibilidade a dano oxidativo no ADN. No entanto, apenas L. aurata capturada em Vagos apresentou frequência de ANE superior à do local de referência. Os dados do estudo sazonal revelaram uma correlação entre dano oxidativo e ANE, sugerindo o stresse oxidativo como um possível mecanismo envolvido na formação de anomalias. A integridade do ADN das guelras, rim, fígado e sangue de L. aurata foi igualmente estudada ao longo de um ano (Capítulo XI), tendo-se verificado uma grande variabilidade ao longo deste período. Não foi demonstrada sensibilidade a um perfil de contaminação específico, tendo-se verificando variabilidade sazonal no local de referência. Globalmente, os resultados demonstraram a importância da utilização de uma bateria de biomarcadores na monitorização ambiental e a especificidade da resposta dos diferentes órgãos de L. aurata.